1.

INNOVATION IN BUSINESS MANAGEMENT AT A PRIVATE UNIVERSITY HOSPITAL:

It is estimated that around 1.3 Billion tons of food is wasted across the planet every year. Out of this
wasted food, almost 1/3 is produced for human consumption. The annual cost of food wasted around
the world is estimated to be around $ 2.6 trillion. This amount is equivalent to provide food to the 815
million people left hungry in the world for four times. Most of the food wasted comprises of food that is
suitable for human consumption but thrown away by end consumer, restaurants, distributors or super
markets. (World Resources Institute). In Pakistan, around 40% of the food is wasted every year (World
Food Programme). This wasted food comes from various food operators including hospitals that serve a
huge number of patients, attendees, staff members and general public for their nutritional needs. The
food operators located inside a hospital contribute up to 50% of the overall hospital waste (Goonan et
al, 2014), an average of 30% of the food prepared in a hospital goes to waste which adds to the overall
losses of such an institution. While many hospitals in Pakistan have tried to address this issue by re-
inventing their strategies, there are not many recorded successes out of their interventions.

The solution to the problem requires innovative thinking and a mixed approach towards the fulfillment
of the prescribed targets of decreasing food wastage and loss while maintaining profitability of the
institution. In this regards, one hospital in Pakistan adopted a new and bold strategy to transform its
Nutrition and Food Services Department into a standalone business entity thereby covering not only its
previous operational losses, but also identifying new income streams to meet its relevant expenditures.
Innovative approach contribute not only to the high productivity of employees within the organization
but also brings about promising outcomes, both financial and social, thus helping that organization
surpass its rivals in the industry (Radhika Kapur, 2020).

The leading private hospital in Karachi employees almost 17,000 individuals. The hospital was
established in 1983 and had a basic structure of providing food services in its common cafeteria. For this
purpose, a food and nutrition services department was established that provided food to hospital staff,
patients and attendees on daily basis. The department was operated with the hospital funds with an
annual estimated cost of Rs. 2.6 mn with -20% revenue generation. Understanding the global impact of
food loss, wastage and cost of living, in 2012, the hospital redefined its strategy of operating food
services at the hospital with the aim to transform the department into an exemplary model for other
healthcare, hospitality and food industry organizations. However, the hospital had been operating its
food service ambit as an additional cost and in an effort to minimize the food operating costs, had
outsourced many of its cafeterias to third party contractors which itself proved to be an additional cost
than a benefit.

Redefining the vision:

After due deliberation among the hospital leadership, it was decided that experts from hospitality
industries should be taken on board with the aim to not only reduce the cost of food production but also
to sustain the department on financial grounds while maintaining the quality of food as per the ISO
22000:2005 and JCIA standards. Another burden on the hospital was the subsidy being provided on food
items to the employees and high food wastage/loss rate at the hospital. In light of these issues, In 2012,
the hospital appointed a former Director of foods and beverages (Mr. Rahim Yaqub) having 25 years of
experience in hospitality industries in Pakistan, Oman and Australia. Rahim took a number of measures
which not only addressed the issues identified above but also anchored the Nutrition & Food Services
Department as a benchmark for Food services operators in hospitality, healthcare, security industries in
Pakistan.
1. Departmental Self-sustainability:
In order to enhance the standard and quality of food services at the hospital campus, Rahim’s
first initiative was to bring the department out of its losses. The hospital has been operating
food services department with no vision of revenue generation. Soon after joining, Rahim
brought a restructured financial management system whereby, the cost control measures were
modified as per the hospitality industry’s best practices. However, this initiative took a lot of
assertion. The hospital had identified and renovated one of its areas into a takeaway shop with
the aim to provide only packets of subsidized food to its employees (one packet per employee).
Rahim took over the designated space and transformed it into an in-house bakery providing the
staff with cakes, croissants and other such items that became popular within the very first
month of inception. Rahim also brought a new image to food services changing it from “food
service operator” into a revenue generating department providing 5 star hotel’s quality, taste
and quantity at minimum prices. The newly installed bakery was projected to generate Rs.
15,000 per day in revenues but the month end report showed Rs. 28,000/- per day of revenue.
This was the first time in years that the food services department had contributed any profits
into the hospital’s income stream. After this, the chain of installing new eateries around the
hospital campus began with the latest eatery being a fine dining restaurant at the new private
wing of the hospital which provides the services standards of 7 star hotels and revenues crossing
Rs. 3 million a month. From year 2012 till year 2021, the departmental revenue had increased
from Rs. 220,000/- to Rs. 2,500,000/.
2. Insourced food services management:
The hospital used to operate its food services through outsourced third party contractors who
would provide food services and catering in off campus cafeterias and/or on campus events
(meetings, town halls, dinners and corporate events). This exercise although increased the
workload on hospital food service staff but over the course of years brought the catering costs
significantly down with almost Rs. 1,000,000/- in revenue from catering services alone. The
hospital had been missing out on this revenue streams.
3. Reduced food wastage/loss:
Rahim brought with himself a vast array of techniques to reduce food wastage and cost of food
production. Rahim began with revisiting the inventory and stock management of the
department. It appeared that food items such as flat breads (Naans), fruits and vegetables were
ordered more than required at a meal time. For example, the consumption of flat bread during
lunch was 3,400 and the amount of flat bread ordered would exceed 3,500. The surplus supply
would then be discarded into wastage thus contributing to the overall food wastage by 3000
flatbreads x 2 meals times (lunch + dinner) a total of 6000 flatbreads each month, which is more
than enough to feed a family of 04 for a whole year. Rahim not only revised the raw and cooked
food material ordering but also re-designed the menus to minimize the ingredients involved. In
addition to this, conserving fruits and vegetables, utilizing left over cakes for fruit trifles, in-
house baked items also reduced the risk of food wastage and loss. Through the said initiatives,
the spoilage was reduced by 80%.
4. Menu reengineering:
It is important that there remains a sense of surprise among the consumers of food services.
Despite providing subsidized food to the hospital staff, the food services failed to retain its food
consumers as most of the staff complained about the taste, quality and quantity of food being
 served. Rahim looked into the recipe standards of each menu item and brought about the
practice of revising the 14 day food menu cycle every quarter to introduce new items that were
not only different each day but were also based on the preferences of the consumers. For
example, the staff belonged to different areas of Pakistan therefore, the menus consisted of a
mix of dishes that are popular among certain ethnicities and also inclusion of eastern and
western items gave the consumers quality meals at an affordable price.
5. Food services branding:
Rahim took a major initiative which although received a huge backlash from the consumers in
the beginning, but later on became a popular feature of the food services department. Rahim
placed the logo of the hospital on all packaging materials, napkins, cutlery and utensils to
enhance the brand name of the hospital and popularize the signature food services among
consumers.
6. New venues and eateries on campus:
As mentioned earlier, opening a new on campus food outlet gave promising response in terms
of revenue and provision of healthy food choices to the food consumers. However, there still
remained some room for innovation and judging by the amount spend by high paid employees
on outside food, Rahim seized the opportunity by introducing a combination of menus including
continental, Chinese, local and Pizzas at a separate cafeteria where the meal would cost higher
but would also bring higher amount of revenue.
7. Minimized loss/spoilage of property:
The hospital faced another major issue. Breakage, spoilage and theft of hospital food service
property. Cutlery, utensils and other such items were lost or broken on a daily basis. In order to
address this major issue, Rahim took a creative step. He first introduced utensils made from high
magnesium compound which would prevent breakage when dropped from a certain height.
After which, the hospital logo was placed on each utensil and cutlery to not only prevent theft
but also work as a branding tool for the food services.
8. In-house catering services:
The hospital management had been missing out on an extremely promising revenue stream.
Major events such as dinners, convocation, gatherings and high profile meetings were
outsourced to catering companies including 5 star hotels. Rahim with his relevant experience,
brought about an in-house solution to this need and introduced a dynamic catering system
backed by a team of industry experts. The catering services not only helped in avoiding the
unnecessary cost of third party caterers but also led to a higher quality of events on campus.
9. Standardized and Controlled meal portions:
Initially there was a complaint among staff of not having enough meal portion or having too
much on the plate that would later be wasted by the end consumer. To solve this problem,
Rahim introduced a practice of standardizing meal portions across the campus thus saving tons
of food waste that was being incurred.
10. Going Green:
The current climate change and global pollution has brought the human carbon footprint to a
threatening level. This threat is furthered by the wastage of food and also the cost of consuming
meals in terms of carbon footprint, resources and finances. As a major initiative in 2020, Rahim
has focused on developing new menus for the hospital comprised of plant based diets,
shortening the vendor delivery distances, emphasis on conserving water and using
biodegradable packaging for food items. Although the cost of such an initiative would be higher
than previous practices, the decrease in carbon footprint from this particular hospital alone
would set an example for the food industry organizations in Pakistan.
The Nutrition and Food Services Department has transformed into a model food services department
and has been replicated in a number of organizations in Pakistan. Apart from learning visits by
universities, the hospital has catered and facilitated numerous organizations in adopting the same
model followed by the hospital so as to train, facilitate and guide the food services industry into
addressing the global food shortage and wastage.

References:

1. Food and Agriculture Organization-United Nations

2. World Resource institute
3. World Food Programme-United Nations
4. Promoting innovations in organizations, Radhika Kapur, 2020

Questions

1. What do you think was the biggest obstacle(s) that Rahim faced at the beginning of his job?
2. Why do you think Rahim went against the instructions of his superiors when developing the staff
takeaway? Share your views on the situation.
3. Do you think that by going green, an eatery may lose its existing Pakistani customers? Why and why
not? Give a detailed analysis.
4. Based on the case study given above, explain in detail how this system can be replicated into
restaurants across Pakistan and why should they bare the additional costs of maintaining hygiene
standards? How will this additional cost be covered?
2. POLICE TRAINING SCHOOL, GARDEN RANGE-KARACHI, PAKISTAN

MODERN POLICING AND POLICE TRAINING PRACTICES

Police is the agency which works as a first line defense against mutiny, insurgency and terrorism related
activities (Abbas, 2009).  The performance of law enforcement agencies is one of the eminent aspects
related to a country’s social environment i.e. the state of peace and order in a country. (Nasar, Sajid
April 2020) In Pakistan, the police is governed by the prescribed rules and regulations of the
constitution. However, with time, the role and scope of policing have evolved and has now become
more than just “Policing”.  Having faced a deepened predicament, both, on the inside, within its police
organization and on the outside, with the public, the police system of 1861 came under strain because
of the social variation brought about during 1947 after gaining freedom from the colonial rule. (Iram
Khalid, 2020).The governance in policing system requires all the characteristics of good governance to
be integrated into the system. Sindh police however, lacks a number of these characteristics. The
situation is so deplorable that an honest police officer cannot survive in the department (Jibran, 2018) 

To address this deficit, a number of interventions such as the Citizen Police Liaise Committee (CPLC) had
been commissioned, apart from this, social service organizations and advocacy campaigns brought
about a positive change in the attitude of the police and their approach towards the job. The need for
community support towards the police was realized after findings coming from the field about
deficiency of police personnel available on duty and the fact that police cannot be present in all areas of
the society at all times. In order to increase the efficiency of controlling and preventing crimes, police
and community coordination has gained much significance with time.

The Police department in Karachi city has over the years lost much of its credibility and popularity
among the citizens. The main contributors to this distrust comprise of dismal performance of the police
and failure to maintain peace in the city. The low performance of police is fueled by increased robberies,
mugging, targeted assassinations and extortions being ignored or in some cases facilitated by the police.
In light of this, the DIG Police, Training, conduct Training Need Assessment and directed the Police
Training School to conduct 60 courses for improvement of investigation techniques, professionalism
among police officers and Behavior Change Communication to improve the quality of Policing in Sindh.

INTERVENTION:

REINSTATEMENT OF THE POLICE TRAINING ACADEMY GARDEN RANGE, KARACHI

1. MANAGEMENT STRUCTURE:

The new principal of the Police Training academy Garden Range, Karachi Inspector Ziaullah carries a
recognized profile of having served Sindh Police in operations and representing Pakistan in United
Nations Peace Missions in underdeveloped countries including South Sudan and Bosnia. After joining the
Academy, Inspector Ziaullah’s method of restructuring the training academy involved redefining the
training modules, engagement of public and private stake holders, appointing relevant field experts for
training courses and redesigning the public image of the Sindh police. Apart from this, the overall
infrastructure of the Police Training Academy also required immediate attention as the building had
weakened structures and obsolete or out of order utilities. To meet this particular challenge, the
principal invited the business community and stalwarts of Sindh police to contribute in revamping of the
Police Training Academy Garden Range, Karachi with training halls and a state-of-the-art I.T. Laboratory
for computer based and online training courses. The major initiative are further explained below:

2. INFRASTRUCTURE

Partnering with organizations and stakeholders is the new way forward for any organization (Public or
private) to progress. Realizing this, the new Principal of PTS Garden reached out to members of business
community and general public through phone calls and letters to introduce the vision of PTS Garden and
the value that is added through the intensive training programs offered by the PTS. After

3. INCORPORATION OF RELEVANT TRAINING PROGRAMS

The problems and background scenario stated above, suggests that there is a strong need of a
revitalizing intervention in the conduct and operations of the Sindh police with regards to their
operational skills sets and personal well-being.

For this purpose, a range of training courses are being proposed for the police officers of grades A.S.I,
Sub-Inspector and Inspector. The training programs shall include topics relating to the day to day
operations, crime scene investigation and interrogation practices of the investigation teams and generic
life skills of the police officers of the identified grades. The training cycle shall be of 3 months each
during which the training courses shall be divided into three major categories identified below:

3. I. Basic policing course:

The basic course shall cover the field staff deployed at their designated stations and locations. This shall
include officers from all tiers i.e. (ASI, SI and Insp.). The objective of the basic policing course is to
familiarize the police officials with the basic values of the policing system and life skills including basic
communications skills, counselling, motivation and time management. This course prepared the officers
to polish their day-to-day practices and public dealing. Officers completing this course shall be qualified
for the second tier of the program. This tier included the following courses:

1. POLICE VALUES (THE RIGHT WAY)

2. LEADERSHIP
3. TEAM BUILDING
4. DECISION MAKING
5. GOAL SETTING
6. COMMUNICATION SKILLS

3. II. Advanced policing course:

In this tier, the police officials shall be given advanced training on skills sets pertaining to investigation
and their advance mode of operations. This shall include community engagement, Crime Scene
Investigation, DNA Evidence collection, processing, Documentation, Interrogation techniques,
leadership, decision making, behavior change communication, Goal setting, personality analysis and
time management. The course shall enable a law enforcer to carry out their operational tasks with
accuracy and in compliance with the standard rules and regulations.

The course outline includes the topics listed below along with their duration. The training team shall
identify and implement the courses after consultation with the in charge of PTS, Garden Karachi Range
so as to avoid any repetition and maximize the efficacy of the program. Each course shall be of 3 days
each and each cycle of training shall run for 3 months followed by thorough impact evaluation. The
courses are listed below along with their details:

1. UNDERSTANDING HUMAN PERSONALITIES AND BEHAVIORS. 

2. PUBLIC RELATIONS AND POSITIVE IMAGE BUILDING
3. BEHAVIOR CHANGE COMMUNICATION
4. TIME MANAGEMENT
5. MOTIVATION
6. CRIME SCENE INVESTIGATION (Homicide)

The courses were projected in mass media and among potential donors including members of business
community to show a new face of the Sindh police and a promising future of policing particularly in
Karachi. The intervention brought positive response from the targeted communities who came in to
support the Police Academy in kind and in monetary terms.

4. HIRING OF FIELD EXPERTS

The committed number of training programs was a huge challenge. Traditionally, such targets were
achieved by delivering basic lectures or avoiding the targets entirely. In past 12 years, less than 5000
police officials were trained. Most of the training programs were conducted by Non Profit Organizations
as their own deliverables. Zia ullah brought a drastic change in this approach, Zia ruled out the
possibility of filling out the papers or relying on external organizations to use the platform of police
academy for their own benefits and began conducting training programs as per the needs identified by
the High Court of Sindh and DIGP South. However, there still remained the challenge of getting the right
resources for the training programs. For this purpose, Zia ullah took out the profiles of trainers who have
conducted training programs from various platforms for the police. After extracting the basic
information and their performance records, Zia ullah personally approached these facilitators and
invited them to join the new pool of trainers for the police academy on various disciplines. It was
clarified beforehand that there4 shall be no monetary gain from these sessions but the
acknowledgement and impact of the trainings shall be enormous. It was this call which convinced many
field experts to join hands with Insp. Zia and conducted training sessions on voluntary basis. The training
programs brought an effective impact on the police force as the training outlines and delivery of the
programs were most relevant to the needs identified and improved the quality of criminal
investigations. Above this, Zia ullah managed to organize more than 50 programs in past 7 months and
trained more than 5,000 police officials which met 100% of the impact in just over 9 months which
previously took 12 years in the past.

Conclusion:

The initiatives mentioned above brought about a positive change yet highlighted a large number of
deficiencies in the policing system. Lack of funds and absence of a strong consistent leadership in the
police has brought a sense of insecurity within the department itself, political involvement is also a
major barrier in the progressive change required in the police. A recommended solution is to declare
Police department as an autonomous institution with its own allocated budget and strong management
systems to ensure its uninterrupted progress.
QUESTIONS –

1. Why do you think the Police Training Academy remained dysfunctional in the past?

2. What difference will it make if Zia Ullah moves on from his position as the Principal of the Academy?
How can his initiatives be sustained?

3. How can the Training Academy help in bridging the gap between the people and the police? Do you
think there is a positive impact of trainings on the overall image of the police among the public? Why or
why not?

4. With the increasing costs and logistical challenges, how can the training programs be sustained and
made cost effective? Share 4-5 ideas and explain them in detail.

REFERENCES
3. PROVIDER ENTREPRENEURSHIP PROGRAM

Literature Review:

Youth between the ages of 10 and 24 make up 25% of the world’s population (UNFPA). 28 million
sexually active adolescents in developing regions do not want a child within two years—and 60% of
these adolescents have an unmet need for contraception (Guttmacher 2016). According to the recent
report of United Nations Development Programme (UNDP), Pakistan has the largest youth population of
64%- Pakistan National Human Development Report (2017). Belief that young, married women should
prove fertility leads to poor-quality sexual and reproductive health care which is evident from the fact
that only 7% of married women is Pakistan 15 – 19 years of age use modern contraception.

There are several contributors to the issue of low contraceptive access for youth. Among them is deep-
rooted beliefs, attitudes, and norms about adolescent and youth sexuality. Health care providers aren’t
immune to these long-held beliefs, attitudes, and norms. In fact, because providers are typically
members of the communities they serve, they often uphold the values and norms of their communities.
Some providers may be unwilling to council to be married young people with contraception, some may
encourage newly married young women to have a child first before using contraception, and others may
withhold certain methods that they deem inappropriate for adolescents and youth, such as long-acting
reversible contraception. As a result, adolescents’ and youths’ health outcomes may be compromised.

Gap Analysis:

Greenstar Social Marketing is the largest social franchising organization working on family planning and
maternal health services in Pakistan. The organization has 25 years of success with major initiatives
spearheaded at local and international levels. The organization provides quality assurance assistance,
healthcare services and affordable/viable family planning services especially to the underserved men
and women (young and adults) in rural, urban and most remote of the areas of Pakistan. These services
are provided through more than 2000 trained healthcare providers located in multiple clinics
(franchises) whilst adhering to the quality standards defined by Greenstar. The healthcare providers are
given supplies, trainings, knowledge, information, channelizing and quality assurance assistance all of
which is funded by major international donor organizations and Government of Pakistan.

However, in 2017, one of the donor organizations, in their program conclusion report shared that many
of the healthcare providers are not able to meet the quality standards or sustain their clinics with over
reliance on donor provided funding which can be an alarm for their clinic’s financial sustainability as well
as the quality of healthcare services being given to the people in need. This brought about the need to
integrate a model of operational practices whereby the providers can sustain their clinics financially
while maintaining the standards of quality outlined by Greenstar. It was also learnt that some providers
are actively discouraging young potential clients (especially newlyweds) from using any family planning
method so as to support early marriage pregnancy thus transforming them into her
delivery/abortion/non-FP service client. Along with being paternalistic in their approach there could be
an economic motivation. The financial prospects of delivery/abortion and other non-FP clients is
potentially higher than providing short term FP services and young recommending any FP method to
young clients may turn into an unwelcomed opportunity cost for the provider. In addition to this, quality
standards require strict implementation of hygiene protocols such as sterilization, disinfection, use of
high quality products and maintaining a certain outlook of the clinic all of which comes at a high price.
As soon as the donor programs pull out the findings, the providers resort to cutting their costs and thus
lowering the quality of healthcare services putting the patients and their clients at a huge risk.

Provider Entrepreneurship program by Zain Aman

Zain Aman is a Business Consultant/ Trainer, organizational Development specialist, a performance

coach and a certified Master trainer on Behavior change communication, PRA, Research Analysis and
Public Health services, having trained more than 10,000 professionals with over 12 years of work
experience in domains of public health, public policy development, donor programs, business
consultation and organizational development. Zain used his past experiences with the healthcare
providers to understand the dynamics of their clinics and how those providers prefer spending their
clinical income without separating the personal expenses from clinical ones. This led to financial
mismanagement of the clinic and in two particular cases, a complete shutdown of the clinics due to
recurring losses. For this purpose, Zain implemented a strategic plan to uplift the it was learnt that some
providers are actively discouraging young potential clients (especially newlyweds) from using any family
planning method so as to support early marriage pregnancy thus transforming them into her
delivery/abortion/non-FP service client. Along with being paternalistic in their approach there could be
an economic motivation. The financial prospects of delivery/abortion and other non-FP clients is
potentially higher than providing short term FP services and young recommending any FP method to
young clients may turn into an unwelcomed opportunity costrevenues of the small scale clinics while
ensuring that the quality of healthcare services are being provided to the patients and the providers do
not discourage or deny any individual from taking up family planning services. despite a contradiction
between profit margins and family planning services, Zain was able to achieve this task through 04 major
initiatives infused into the program framework.

Program framework:

1. Establishing uniform criteria for entrepreneurship program:

20 Greenstar network providers were selected through random purposive sampling technique whereby,
providers with equal level of qualification from Karachi city were selected, interviewed and further
shortlisted for Provider Entrepreneurship Program. Main emphasis was given to keep a uniform profile
of the providers so as to ensure maximum effectiveness of the program. Initially, a uniform selection
criteria was developed after which, 53 providers were physically visited by Greenstar representatives
and Business Consultant and after conducting an “urgency assessment” for a business plan, providers
were invited to join this program by expressing their written consent on a provider consent form. After
further screening of profiles, 33 providers were invited for the orientation program.

2. Selection for Providers for induction and orientation:

Providers were given a general orientation about the entire program with detailed elaboration of how
this program proposes to uplift the revenue generating capacity of each provider’s clinic as a business
outfit. The purpose of this session was to ensure commitment and interest of each provider into the
program with the aim to identify and select only those providers who wish to participate in the program
with the intention to continue the business management practices in future. After a thorough
evaluation, 20 out of 33 providers were selected for the program.

3. Training of the selected group:

After selection, Zain imparted a 05 day training programs for the selected providers. This was doen after
a thorough needs assessment of the providers and the course outline was designed specifically to
address the providers’ needs. This course outline included the following topics:

1. COMMUNICATION SKILLS
2. MOTIVATION
3. BEHAVIOUR CHANGE COMMUNICATION
4. CUSTOMER CARE
5. TIME MANAGEMENT
6. GOAL SETTING:
7. RECORD KEEPING Basic accounting principles, Inventory management, Client record
keeping

8. Branding/Marketing
9. PEST ANALYSIS
10. INFECTION PREVENTION
11. SAFETY AND SECURITY
12. BUSINESS ANALYTICS
13. BUSINESS PLANS DEVELOPMENT
4. Business Planning/Implementation/Monitoring and Coaching:
After conducting the training programs, Zain helped each provider in developing tailored strategic plans
for the uplift of revenues and quality outputs of each providers’ clinic. The business plans were made
using an easy to use tool for the providers which helped them keep a tracvk of their goals and keep an
eye on their own progress. Zain helped the providers in understanding the importance of re-investing
the profits back into the businesses and how the providers can generate funds for starting up their
designed business plans with the intention of expanding and increasing the scope of their services.
The results:

Despite numerous challenges and initial reluctance from the providers, Zain was able to generate the
unforeseeable performance from the target group with noticeable results. Overall income and profit
trends showed positive growth for each month preceding month from April 2018. The overall Profits of
the entire group in January stood at Rs. 702,434/- (Seven hundred two thousand four hundred and thirty
four only) which rose to Rs. 1,103,400/- (One million one hundred three thousand and for hundred only)
with approximately 36% growth in four months of the intervention. OPDs remained same as during the
implementation of the plans, part or all of each clinic had to be closed for infrastructural development.
Providers were performing resident OPDs during that time.

Family planning clients have grown during the intervention with FP clients rising from 388 in January to
660 in April which shows a 41% rise due to the PEP intervention. Business analysis also showed that each
provider incurs an average cost of Rs. 15 for providing a short term FP method to a client whereas Rs. 60
for each long term method excluding TL and Implant. These costs include the running expenditures as
well as the utility expenses. On average providers earn Rs. 20-30 for each short term FP method and Rs.
250-500 for each long term FP method excluding TL and Implant.
Overall performance of the target group:

A. Financial:

B. OUT PATIENT DISPENCARY (OPD) TURNOVER:

c. FAMILY PLANNING CLIENTELE:

 During the intervention following observations were also made:
 Initially providers were reluctant in disclosing their actual income, expenditures and profits in
fear of possible implication of commercial billing and taxes at their clinics. Green Star and
Business Consultant assured them of non-disclosure of their income and profits outside of its
parameters.
 Providers who implemented their marketing plans such as giveaways, Boards, Visiting cards,
Client Referral and group discounts have seen an average increase in their clientele by 40%.
 Communication gap providers and Green Star sales team was observed. 4 providers did not
receive their requested supply of FP products which led to a decline in their FP clientele by
average 22%.
 Providers require business relationship officers who can help the providers in implementing their
business plans, liaise them with Town health Officers, procure any clinical related items, identify
vendors for the clinic and communicate providers’ concerns, grievances, recommendations and
comments to Greenstar on timely basis.
 Two providers (requesting anonymity) complained that the IPC workers assigned to their clinics
were not generating any new clients and spent most of their time sitting at the clinic. Providers
gave these workers names and details of their existing clients so that the workers could report
them as their own and save their jobs.
 Uneducated people often ask about medicine to eliminate a conception and consult with local
medical stores to take the medicines.
 The intervention has shown 36% increase in profits of clinics and 41% increase in clientele in just
4 months and carries the potential to increase both elements by 144% and 164% respectively by
end of one year.

Some examples from the field:

Farhana started her clinic with her husband looking after their children, she has been looking for
opportunities to enhance her clinical operations but always remained in fear of having
representatives from health department shutting down her clinic.
 After implementation of the PE program, Farhana revamped her clinic by knowing about her
rights, duties and scope of services so that she can serve her clients as per the health
department guidelines.

Data analysis:

Goals and Objectives:

Conclusion:

Organizations working on public health in Pakistan have been delivering results above and beyond their
capacity due to the weak infrastructure of the government institutions. However, there remains an
uncertainty among these organizations with regards to the behavior of the donor agencies that pull
away their funding due to multiple reasons which in turn puts these organizations and their operations
at the risk of closure. Through the Entrepreneurship Program, Zain proved that through strategic
financial and operational planning, the risk of uncertainty can be reduced with low dependence on
external donors for bridging the gap between public health needs and provisions. Zain’s successful
intervention resulted in expansion of the Entrepreneurship Program to 2,000+ healthcare providers
across Pakistan and an industrial benchmark for other organizations.

Questions:

1. What challenges did Zain face for convincing the providers in participating into their programs?

2. Donor Programs in Pakistan are beginning to reduce their funding to social services programs in the
country. How can these programs be sustained in the absence of such donors?

3. Should the government rely on Non-Government Organizations for delivering their committed
servics? Why and why not?

4. How would you implement Zain’s model into the education sector of Pakistan? Give innovative
ideas to your approach.